One of the more vexing issues that the no-fault practitioner encounters on an almost daily basis is determining the proper no-fault rate or fee schedule amount for medical services that are covered under the New York no-fault law.1 This article will serve as a primer to help the attorney better understand the fee schedule. It will also specifically discuss two of the more common fee schedule issues faced by the practitioner.
Section 5108(a) of the Insurance Law provides that the charges for services that are medically necessary under the no-fault law “shall not exceed the charges permissible under the schedules prepared and established by the chairman of the Workers’ Compensation Board for industrial accidents.” Thus, the starting point for all fee schedule questions under the no-fault law is the Workers’ Compensation Fee Schedule.
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